How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | None | $70.79 | $74.13 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $154.88 | Professional | None | $100.00 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $245.47 | Facility | None | $144.54 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
ConnectiCare Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $257.04 | Professional | None | $154.88 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $141.25 | Professional | None | $114.82 | $125.89 | $141.25 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.13 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $7.41 |
Where Connecticut sits
The same service costs 3.6 times more in Wyoming than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 31st of 51
$126
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.